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0404-041 (ELEC) LICENSED CONTRACTOR DECLARATION PERMIT# U I hereby affirm under penalty of perjury that I am licensed under provisions of BJILbING PERMIT 04 .041 H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and DATEVALUATION v LOT TRACT N W Professionals Code,and my License is in full force.and effect. 2o4 Ar � o C.,) License# Lic.Class" Exp.Date JOB SITE wJAI i A-Signature C45 J.j rM r � �� � ADDRESS ��k�NFUNUE 47 S TF -2 APW {` V�m t OWNER CONTRACTOR/DESIGNER/EN (NEER Z Date of Contrac or O' i 1E-I r I IMM,LLC WRKRTAIL S.ION C.0. r- ~ o OWNER-BUILDER DECLARATION —J ° 45.524.`i OWNE 1°37K1"Ir't 46120 CALHOUN W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's , E— a MD10 x'2201 bYD10 Citi 921201 License Law for the following reason: Z ( ) I, as owner of the property, or my employees with wages as their sole 07603347.3565 CYSL# 223 compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professionals Code). USE OF PERMIT ( ) I, as owner of the property, a( exclusively contracting with licensed TS1�?�w�,y�a",,ikil pIII�IIIIIIIIIIIIIIIIIIIII 1 contractors to construct the project Sec. 7044, Business & Professionals 38C Code). IE,LUhiINA.TE D CM4Ni±I,LETTER,SIONS(2)ftR SA 04.7$1. 2001 C11C. IE �I () I am exempt under Section , B&P.C.for this reason LO _ O N Date Signature of Owner 0)a Q WORKER'S COMPENSATION DECLARATION It Z I hereby affirm under penalty of perjury one of the following declarations: � Q rr V-ALUA.TION 440MDOL8 r O ( ) 1 have and will maintain a certificate of consent to self-insure for workers' X•W compensation, as provided for by Section 3700 of the Labor Code, for the O _ Q performance of the work for which this permit is issued. m Q U ( ) I have and will maintain workers'compensation insurance, as required by O Q Section 3700 of the Labor Code, for the performance of the work for which this LO fl rn H permit is issued. My workers' compensation insurance carrier & policy no. are: 1�4Z Carrier STATE-MiZ . Policy No. 14248"-02 EMUI TED COST OF CON:c'3`RU 'tPJN 4,0W.00 J (This section need not be completed if the permit valuation is for$100.00 or less). OTRIt".1,RZ 101.000-20.000 F:t3.00 ( ) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become a subject to the workers'compensation proVlslons of Section 3700 of the Labor D 0 Code, I,shal!forthWith comply with Those pr�v sions. Date'-41 7) r1V( Applicant— Warning: - 5 2004 • Warning. Failure to secure Workers' Compensation coverage is unlawful and APR 4 shall subject an employer to criminal penalties and civil fines up to$100,000, in UINTA addition to the cost of compensation,damages as provided for in Section 3706 CITY OF jEPT. �Q of the Labor Code, interest and attorney's fees. FINANCE DEPT. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1.Each person upon whose behalf this application is made&each person at S.xl3-T'f.�l 1 1"Ril °07(01$ .s a kyi,. 4 CjMe.T.,3 ,()0 whose request and for whose benefit work is performed under or pursuant to LFINS PJi�)xrj 1WE;3 S0100 any permit issued as a result of this applicaton agrees to, &shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2.Any permit issued as a result of this application becomes null and void if "r'UF AL B24KIr YKES UST:400 work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is • correct. I agree to comply with al1`City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned properiy.for inspection purposes. t fr 6 Wyly RECEIPT DATE% — 4� c=BY ��'' DAT NALEDn INSPECT ✓Signature (Owner/Agent) 1i Date 4/� J7It(f. INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms&Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K.to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans&Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall-Int.Lath Final Final POOLS - SPAS BLOCKWALL APPROVA S Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg.Test Final I I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure M Shower Pans OX for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice(Gas) ELECTRICAL APPROVALS Temp.Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels T Exterior Receptacles G.F.I. uti Smoke Detectors Temp.Use of Power Final Utility Notice(Perm) • f - COMPANY: COFFEE BREA%CAFE REF: 207136,3C45OLIC. C10, C61 • ' • ' .' ADDRESS: 78-900 AVENUE 47 SUITE 100(Vista la Quinta) CITY: LA QUINTA CA. 02113104/04 WORBMANS COMP# . . " •" • . L f 1 42483 7-01 •. .- PHONE: FAX: 1 CITY LICENSE# '" 46.120 CACHOUN ST.INDIO.CA 07201 JOB ADDRESS: 78-900 AVENUE 47 SUITE 100(Vista la Quinta) CITY: LA QUINTA CA. COFFEEB CAFE 00223 80 347 3668 FAX 60 347-030.9 Channel Letters Specifications (Flush Mounted) 20 AMP 120 VOLT PRIMARY ELECTRIC j X Approved by: Q eso # CIRCUD(PROV OED BYOTHERS) Aill ',, .•�.yj /� TRIMLAP gr :�'• T1 Plannin Commission METAL RETURNS L° Ca '�+ PLEXIGLAS FACE91I .y, Cil STANDARD GLASS NEON TUBE SUPPORT ;J !"' METAL BACK ,'iin Brea It oev. !,e Coffee PNEON TUBING ( n Initial ELECTROBRS NEON CONNECTORS :r i' O 12 1 II . a W/PJUNL ,,lii� -6 as OTION BOR(PROVIDED BYDrHERS) O VV��11 ��� HI VOLTAGE GTO WIRE FEED THRU BUSHING 13.54 SdElfibit %•CONDUIT CONNECTER ❑ With Conditions 120VOLTPRIMARYWIRING WITHIN Ipr' CONDUD CONNECTER TXRU r WALL TO TRANSFORMER I' METAL RALEWAYWIIH aifN' CITY OF LA QUINTA NSU LATEDOISLONNELT SN CH IN END OF RACEWAY ,+' m-;'{•f lB CREW9 INID WALL i1:'/• •LSF BUILDING &SAFETY DEPT. VW DIA WEEP HOLES 6 COVERS A9 FRONT ELEVATION APPROVED REAR ELEVATION REQUIRED "IIr ;II (Avenue 47) FOR CONSTRUCTION (Parking Lot) EXTERIOR LETTER INSTALLATION!INTERIOR 5ECONDARY NRING y n THIS SIGN IS INTENDED TO BE INSTALLED IN ACCORDANCE WITH THE REQUIREMENTS E.Q OF ARTICLE 600 OF THE NATIONAL ELECTRICAL CODE AND/OR OTHER APPLICABLE E.Q. E.Q. DTE BY 1 LOCAL CODES. THIS INCLUDES PROPER GROUNDING AND BONDING OF THE SIGN. Circuit to sign location to be within 12'fleet at CLEAR Workable'I'Accessible area.'AND may be subject ro ba on a dedicated line and labeled as per city a County coda. •-+••-i-•----- 13' 10" Co1i•Break CBf� �coaea Break Cafoi - e.a BOTTOM OF SIGN 3 k Site Plan Plot Plan F.G. ` 1111 11 DESIGNATED SIGN LOCATION 2'x 12'-6" p" ^•�, ,, INTERNALLY ILLUMINATED CHANNEL LETTERS COLOR:BLACK/WHITE TRIM:GOLD COLOR ar RETURN:BRONZE DESIGNATED VINYL LETTERING LOCATION 18"X18" 1'/2' HIGH LETTERS OFF WHITE COLOR 4�4FJ, a NOTES: 21NTERNALLYILLUMINATED CHANNEL LETTERS COLOR:BLACKIWHITE TRIM:GOLD COLOR RETURN:BRONZE 2 VINYL LETTERING OFF WHITE COLOR CUSTOML AND ARE L •- •- PRODUCTS THAT ARE • OF • ARE • , : CLIENT APPROVAL: IT IS IMPERATIVE THAT YOU TAKE THE TIME TO: (1) REVIEW EVERYTHING, (2) MAKE NECESSARY CHANGE(S), (3) UNDERSTAND EVERYTHING PRIOR TO SIGNING THIS DRAWING. DRAWINGS WILL BE USD • -• • • PRODUCT. •- RETURN TRIPS WILL BE THE SOLE •• OF • BOTH LEGALLY AND LANDLORD APPROVAL: FINANCIALLY. • DRAWINGS AND INSTALL DRAWINGS - • CITY, LANDLORD, SUPERVISOR AND •- CLIENT DEMANDS. COLOR(S) WILLVARY • REPRODUCTION. • PROCESSING. AND OTHER TYPES OF LTING/REP LOCATING PROCESSES/DEVISES. •• OF • NOTE AND/OR INSUREDRAWNBY THE EXACT COLOR(S). NOTE:PLEASE ALL OW AT LEAST 4-6 WEEKS UPON CONTRACT DEPOSIT, PERMITS AND "SIGNED"DRAWINGS, Jose costa 05/28/2004 14:39 7603242253 LATHROP DEVELOPMENT PAGE 01/01 I11131llll 1111111111139 RIVERSIDE COUNTY FIRE DEPAIMENT I IE IN COOPP-RATION WITH CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION 4080 LEMON ST:zEE`T,2ND FLOOR � r ...-_ �.•3 r - P.0-BOX 1549 Cbuxrr� ( RtVER$li)F,, cA 92502-1549 arvsl+srnia.. (909)9554777 'AX(909)955-4886 JOB CARD THIS INSPECTION RECORD MUST BE AT JOB SITE WITH THE APPROVED SET OF PLANS Owner o I?ate c4 Location' 718- _ Case No. Sprinkler Company sc Underground Visual Date inspector (Joints and Thrust Blacks Most Be E)pos2cl) Underground static ©ate Inspector (200 PSI Far 2 H�rs.,Prior to innspeodon 7►me) dergrourt�U Flush fate Inspector r �� ,� • �Date Inspector Overhead Final Date fns rAOr Fire main Installer Underground Visual Date Inspector (Joints and Thrust Flocks McrS(Be Hosed) Underground Static Date inspector (200,PS/For 2 Hrs Prior to Insp 'on Time) • i Underground Flush Date Inspector g